Dupilumab and House Dust Mite Immunotherapy in Patients with Atopic Dermatitis: A Preliminary Study

Background: Severe atopic dermatitis (AD) is a complex disease requiring systemic treatment. This study aimed to assess the effectiveness of combined therapy consisting of dupilumab and sublingual dust mite allergen immunotherapy (SLIT-HDM) in patients with severe AD and HDM allergies. Methods: Pati...

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Main Authors: Agnieszka Bogacz-Piaseczyńska, Andrzej Bożek, Magdalena Krupka-Olek, Aleksandra Kawczyk-Krupka, Jolanta Zalejska-Fiolka, Giorgio Walter Canonica
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Language:English
Published: MDPI AG 2024-09-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/12/9/1046
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author Agnieszka Bogacz-Piaseczyńska
Andrzej Bożek
Magdalena Krupka-Olek
Aleksandra Kawczyk-Krupka
Jolanta Zalejska-Fiolka
Giorgio Walter Canonica
author_facet Agnieszka Bogacz-Piaseczyńska
Andrzej Bożek
Magdalena Krupka-Olek
Aleksandra Kawczyk-Krupka
Jolanta Zalejska-Fiolka
Giorgio Walter Canonica
author_sort Agnieszka Bogacz-Piaseczyńska
collection DOAJ
description Background: Severe atopic dermatitis (AD) is a complex disease requiring systemic treatment. This study aimed to assess the effectiveness of combined therapy consisting of dupilumab and sublingual dust mite allergen immunotherapy (SLIT-HDM) in patients with severe AD and HDM allergies. Methods: Patients diagnosed with severe AD were included in this randomised, placebo-controlled, double-blind 12-month trial; they received SLIT for HDMs and/or dupilumab for 12 months and were compared with patients on cyclosporine. The primary outcomes for the treatment arms were changes in the Eczema Area and Severity Index (EASI), body surface area (%BSA), and Investigator Global Assessment (IsGA) over 12 months. The secondary outcomes were the proportion of patients who achieved IsGA success and reduced medication scores. Results: Significant improvements were observed in all analysed groups after 12 months of therapy based on the EASI, %BSA, and IsGA. However, the most substantial changes were observed in the groups treated with dupilumab or a combination of SLIT-HDM and dupilumab. Additionally, the proportion of patients who achieved an IsGA reduction was significantly greater in the group receiving combination therapy than in the other groups (9/14 [64% of the group receiving SLIT-HDM] vs. 11/14 [73% of the group receiving dupilumab] vs. 15/17 [88% of the group receiving dupilumab and SLIT-HDM] vs. 7/13 [53% of the group receiving cyclosporine]) (<i>p</i> < 0.05). Conclusions: In patients with severe AD and HDM allergies, combination treatment with dupilumab and allergen immunotherapy for HDMs may increase the therapeutic benefit over treatment with these methods separately.
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spelling doaj-art-b5efcd04b5c04a19abe47dc19e70e7442025-08-20T01:55:57ZengMDPI AGVaccines2076-393X2024-09-01129104610.3390/vaccines12091046Dupilumab and House Dust Mite Immunotherapy in Patients with Atopic Dermatitis: A Preliminary StudyAgnieszka Bogacz-Piaseczyńska0Andrzej Bożek1Magdalena Krupka-Olek2Aleksandra Kawczyk-Krupka3Jolanta Zalejska-Fiolka4Giorgio Walter Canonica5Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, 40-055 Katowice, PolandClinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, 40-055 Katowice, PolandClinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia, Batorego 15 Street, 41-902 Bytom, PolandDepartment of Biochemistry, Faculty of Medical Science, Zabrze Medical University of Silesia, 40-055 Katowice, PolandHead Personalized Medicine Asthma & Allergy Clinic-Humanitas Research Hospital, Humanitas University, 20089 Milano, ItalyBackground: Severe atopic dermatitis (AD) is a complex disease requiring systemic treatment. This study aimed to assess the effectiveness of combined therapy consisting of dupilumab and sublingual dust mite allergen immunotherapy (SLIT-HDM) in patients with severe AD and HDM allergies. Methods: Patients diagnosed with severe AD were included in this randomised, placebo-controlled, double-blind 12-month trial; they received SLIT for HDMs and/or dupilumab for 12 months and were compared with patients on cyclosporine. The primary outcomes for the treatment arms were changes in the Eczema Area and Severity Index (EASI), body surface area (%BSA), and Investigator Global Assessment (IsGA) over 12 months. The secondary outcomes were the proportion of patients who achieved IsGA success and reduced medication scores. Results: Significant improvements were observed in all analysed groups after 12 months of therapy based on the EASI, %BSA, and IsGA. However, the most substantial changes were observed in the groups treated with dupilumab or a combination of SLIT-HDM and dupilumab. Additionally, the proportion of patients who achieved an IsGA reduction was significantly greater in the group receiving combination therapy than in the other groups (9/14 [64% of the group receiving SLIT-HDM] vs. 11/14 [73% of the group receiving dupilumab] vs. 15/17 [88% of the group receiving dupilumab and SLIT-HDM] vs. 7/13 [53% of the group receiving cyclosporine]) (<i>p</i> < 0.05). Conclusions: In patients with severe AD and HDM allergies, combination treatment with dupilumab and allergen immunotherapy for HDMs may increase the therapeutic benefit over treatment with these methods separately.https://www.mdpi.com/2076-393X/12/9/1046atopic dermatitisimmunotherapydupilumabhouse dust mites
spellingShingle Agnieszka Bogacz-Piaseczyńska
Andrzej Bożek
Magdalena Krupka-Olek
Aleksandra Kawczyk-Krupka
Jolanta Zalejska-Fiolka
Giorgio Walter Canonica
Dupilumab and House Dust Mite Immunotherapy in Patients with Atopic Dermatitis: A Preliminary Study
Vaccines
atopic dermatitis
immunotherapy
dupilumab
house dust mites
title Dupilumab and House Dust Mite Immunotherapy in Patients with Atopic Dermatitis: A Preliminary Study
title_full Dupilumab and House Dust Mite Immunotherapy in Patients with Atopic Dermatitis: A Preliminary Study
title_fullStr Dupilumab and House Dust Mite Immunotherapy in Patients with Atopic Dermatitis: A Preliminary Study
title_full_unstemmed Dupilumab and House Dust Mite Immunotherapy in Patients with Atopic Dermatitis: A Preliminary Study
title_short Dupilumab and House Dust Mite Immunotherapy in Patients with Atopic Dermatitis: A Preliminary Study
title_sort dupilumab and house dust mite immunotherapy in patients with atopic dermatitis a preliminary study
topic atopic dermatitis
immunotherapy
dupilumab
house dust mites
url https://www.mdpi.com/2076-393X/12/9/1046
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